Professor Carol Newman, Trinity College Dublin

Wednesday January 31st 2018, 1430-1600, BDO Library

So fresh and so clean: urban community engagement to improve the sustainability of drainage infrastructure

Abstract

Rising sea levels and recurrent stormwater flooding threaten infrastructure, livelihoods, homes and lives in coastal cities around the world. This is particularly the case in developing countries where drainage and other flood-related infrastructure is poorly developed or obsolete. Building resilience requires significant infrastructural investments but also requires the engagement of communities in the preservation and maintenance of infrastructure and public spaces. This is challenging as little is known on how best to engage communities in the preservation of public spaces, particularly in urban settings. In this paper, we use an experimental (randomized controlled trial) method to test the effectiveness of an intervention designed to motivate community members to keep their local area clean, thereby increasing the effectiveness of drainage infrastructure and reducing the risk of flooding in that area. Our sample consists of 160 randomly selected quartiers (communities). The program targets established community-based groups within treatment quartiers and provides them with a non-monetary incentives-linked "social contract", called "Operation Quartier Propre" (OQP), to maintain and preserve public spaces by keeping them trash free. We test whether community engagement is improved through OQP and also examine the impact of this intervention on outcomes relating to health, education and livelihoods. We find that the program had a significant positive effect on households' likelihood of receiving training and their perception of the cleanliness of their neighborhood. There is also some evidence that this reduced their experience of flood-related illness and income lost due to flooding. However, the results show limited impact on objective measures of cleanliness of the local area.

ARK, School of Social Sciences, Education and Social Work, Queen’s University Belfast.

Research on ageing has not tended to take first-hand experience of living a long life as its primary data source. As such, it differs from race and gender studies, which are founded on the writings of people of colour and women. However, some older women, including ageing feminists, have begun to write about the experience of longevity. These new forms of ‘situated knowledge’ potentially help us to gain a greater understanding of ageing in social and cultural terms.

The Lively Project took its inspiration from Penelope Lively’s memoir, Ammonites and Leaping Fish: a life in time. Lively’s description of how six personal possessions tell the story of her life, show how a lifetime is shaped by socio-historical change. The objects place her 80 years on Earth in context. Our project replicated this experiment by asking six people (aged 61 to 80) to choose six objects that articulate something of their lives. This pilot project tested multiple methods from arts and public engagement to investigate whether objects help us to communicate the value of living a long life. This paper shares learning from this project, and will be of interest to those working with arts and older people, arts in health care or those interested in informing public debates on ageing.

Friday 19th May 2017, 3.30pm, QMS Lecture Theatre

Can a major shock in childhood permanently shape trust? We consider a hunger episode in Germany after WWII and construct a measure of hunger exposure from official data on caloric rations set monthly by the occupying forces providing regional and temporal variation. We correlate hunger exposure with measures of trust using data from a nationally representative sample of the German population. We show that individuals exposed to low caloric rations in childhood have significantly lower levels of trust as adults. This finding highlights that early-life experiences can have long-term effects in domains other than health, where such effects are well-documented.

The purposes of this paper are to describe some conceptual and empirical foundations of "healthy-time" measures of health outcomes or healthcare quality, and to explore how to expand the empirical opportunities for measuring such outcomes using U.S. national survey data. To these ends, the paper provides an overview of Grossman's seminal health production framework, surveys some of the healthy-time outcome/quality measures in use across a variety of contexts and applications, explores how data from the U.S. Medical Expenditure Panel Survey (MEPS) might be used to develop ongoing healthy-time measures for U.S. samples, describes an econometric strategy for studying such outcomes, and presents estimates of regression models describing two sets of healthy-time outcome measures obtained from 2011 and 2012 MEPS data.

Bio

John Mullahy is Professor of Health Economics in the Department of Population Health Sciences, Affiliate Professor at the La Follette School of Public Affairs, Co-Director of the Robert Wood Johnson Health & Society Scholars Program, and Co-Director of the NIMH training program in Health and Mental Health Economics, all at the University of Wisconsin-Madison. He is also Honorary Professor of Economics at NUI Galway and Research Associate at the National Bureau of Economic Research. He currently serves as Co-Editor of Health Economics and is a member of the editorial board of Health Services and Outcomes Research Methods and International Journal of Health Economics and Management. He was formerly Associate Editor of Journal of Health Economics and was previously guest editor on JRSS-A: Regional Science and Urban Economics: Empirical Economics and Economic Modeling.

The provision of a robust protocol for the development of country specific preference weights makes possible the comparative analysis of preference weights between countries using the EQ5D5L instrument. The protocol also facilitates a more robust analysis of heterogeneity of preferences within countries than would otherwise be possible. In Ireland a mixed public/private system of health care funding and provision exists. Debate exists as to whether observed differences in service use between groups differentiated by possession of private health insurance relates to differences in access to care or differences in preferences for health.

Aims

To compare the values attached to health states measured using the EQ5D5L instrument between individuals differentiated by possession of private health insurance in Ireland.

Methods

1160 usable surveys were collected based on the EuroQol protocol between March 2015 and September 2016. Main effects were estimated and compared using a hybrid TTO/DCE model for the entire sample and sub-samples differentiated by insurance status. A comparison of main effects based solely on TTO results in which insurance status was entered as a dummy variable was also undertaken.

Results

Estimation of the main value set using the hybrid DCE/TTO model of the full sample revealed no inconsistencies in the ranking of health states. A comparative analysis of the main effects model on groups differentiated by insurance status revealed a significant difference in only one level of one health domain (anxiety/depression, level 3) between groups. Those with private insurance valued this level of this domain relative to no problems with anxiety/depression marginally higher than those without insurance. Separately an analysis in which insurance status was entered as a dummy variable in a main effects model showed no significant differences between those with and without insurance.

Discussion

The findings indicate that preferences for health in Ireland do not vary materially between groups differentiated by insurance status. The value set will be useful to the conduct of health technology assessment in Ireland. Its finding also have important implications for our understanding of observed differences in publicly funded healthcare use related to insurance status.